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Food Insecurity And Parent Engagement In Pediatric Therapy: A Comparative Study Of Feeding, Speech-Language, And Combined Services, Kendra Kendra Rosales

Open Access Theses & Dissertations

Pediatric feeding disorders and food insecurity represent two compounding challenges for families navigating pediatric therapy services, yet their intersection has received little empirical attention. This study examined food insecurity rates across three pediatric therapy groups and explored the relationship between food insecurity and parent engagement in therapy. A cross-sectional online survey was administered to 175 caregivers of children actively receiving feeding therapy only (n = 34), speech-language therapy only (n = 93), or combined feeding and speech-language therapy (n = 48). Food insecurity was assessed using the USDA Household Food Security Survey Module: Six-Item Short Form, and parent engagement was …

The Future Midwife: A Prisma Scoping Review Of Education, Transition, And Work Readiness Among Midwifery Students, Danielle Gleeson, Tracey Tulleners, Jessica Elliott, Dianne Stratton-Maher, Liz Ryan, Jillian Mcculloch, Geraldine Roderick, Thenuja Jayasinghe, Joanne Buckley, Jamie May Newman, Helen Nutter, Jo Southern, Lisa Beccaria, Georgina Sheridan, Tess Trinder, Haiying Wang, Tao Wang, Sita Sharma, Linda Ng, Jing Yu Tan, Daniel Terry

Research outputs 2022 to 2026

Background: Preparing midwifery graduates to be confident, competent, and resilient is essential for workforce sustainability, yet students report a disconnect between academic preparation and clinical realities. Increasing care complexity, workforce shortages, and variable clinical learning environments globally highlight the need to examine how educational strategies support effective transition to practice. Objective: To map and synthesise the evidence regarding educational approaches, learning experiences, and transition-to-practice factors that influence preparedness for professional practice among midwifery students, and to identify gaps in the existing literature to inform a coherent and future-ready educational framework.

Methods: A PRISMA-ScR-guided scoping review was conducted across seven databases. …

Utilization Of An On-Site Primary Care Clinic – An Evaluation, Joulvous Jarvis Drake

Doctor of Nursing Practice Projects

Background: Employers incorporate on-site primary care clinics into their workplace health strategies to improve employees’ access to timely care and chronic disease management and reduce absenteeism and healthcare-related costs. Yet despite the demonstrated organizational and health benefits, many worksite clinics experience lower-than-expected utilization. Purpose: This evaluation project aimed to identify the behavioral and structural factors that influenced employee utilization of a corporate on-site primary care clinic. Method: A quantitative, cross-sectional design was used to evaluate the factors contributing to employees’ low utilization of the on-site primary care clinic. Approximately 1,000 eligible full-time employees at a large corporate campus in Texas …

Increasing Human Papillomavirus Vaccination Rates Among Adolescents In The Primary Care Setting: A Quality Improvement Project, Chioma Rosemary Ike

Doctor of Nursing Practice Projects

Background: Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States. It is the most common viral infection of the reproductive system, and it is responsible for most cervical cancer cases worldwide. Many HPV-related cancer deaths can be prevented simply through vaccination. The vaccine is most effective when administered before exposure to the virus. Despite the HPV vaccine’s proven safety and efficacy, its uptake remains suboptimal. Purpose: This quality improvement (QI) project trained providers at a pediatric and family clinic in an effective communication strategy to increase HPV vaccination uptake among adolescents. It encouraged providers to …

The Impact Of Enhanced Pediatric Asthma Simulation Prebriefing On Perceived Psychological Safety In Associate Degree Nursing Students, Amy G. Burtram

Theses

Background: Simulation is a core teaching strategy in nursing education, yet student anxiety may negatively impact learning outcomes. Psychological safety has been identified as a critical factor in effective simulation-based student learning.

Purpose: The purpose of this project was to examine whether an enhanced simulation prebrief improved perceived psychological safety among second-semester associate degree nursing students during a high-fidelity pediatric asthma scenario at a rural community college in Alabama.

Methods: A quasi-experimental one-group pretest–posttest design evaluated changes in psychological safety following a structured, evidence-based prebrief grounded in the International Nursing Association for Clinical Simulation and Learning (INACSL) Healthcare Simulation Standards …

Exploring Perceptions Of Self-Efficacy Among Newly Graduated Nurses In The Labor And Delivery Unit After The Use Of Rapid Cycle Deliberate Practice For Obstetric Emergencies, Amber L. Hulsey

Dissertations

Background: The average turnover rate among newly graduated nurses (NGNs) in the United States is 25-30% within their first year, with increased rates in high-stress units like obstetrics and critical care. Many risk factors contribute to the high turnover rate of NGNs, but one modifiable factor is feelings of self-efficacy. Studies have shown that simulation training can increase self-efficacy in obstetric emergencies. This study was conducted to explore feelings of self-efficacy among NGNs working in the labor and delivery unit after a rapid cycle deliberate practice (RCDP) simulation of an OB emergency.

Methods: The study used a descriptive …

The Use Of A Sepsis Escape Room Simulation To Enhance Undergraduate Nursing Student's Clinical Judgment, Alaina Peterson

Dissertations

Background: Less than 10% of new graduate registered nurses meet practice-ready expectations for clinical judgment competencies, and 52% of critical care nurses are unable to adequately define sepsis. Traditional clinical rotations offer inconsistent exposure to high-acuity, low-frequency events such as sepsis, leaving new graduates unprepared for independent practice. Escape room simulations use the proven effectiveness of high-fidelity simulations with gamification to develop clinical judgment through active learning, teamwork and problem-solving.

Objective: The purpose of this project was to determine the effectiveness of a sepsis escape room simulation to improve perceived clinical judgment skills of undergraduate nursing students. The intervention was …

Evaluation Of A Streamlined Insurance Advocacy And Pre-Authorization Process For Hormone Replacement Therapy, Ellison Edwards

Walden Dissertations and Doctoral Studies

This organizational process evaluation project addressed the high rate of insurance denials for hormone replacement therapy (HRT) for women with symptomatic menopause and "normal" laboratory values within a private primary care setting. The practice problem involved bureaucratic barriers in the front office and a lack of structured advocacy, which delayed patient access to evidence-based care. The purpose of this project was to evaluate the impact of a streamlined insurance advocacy and pre-authorization process on access to therapy. The project utilized a standardized "Insurance Advocacy Toolkit" and evidence-based templates aligned with the 2023 North American Menopause Society (NAMS) guidelines. Analytical strategies …

A Proposal For A Nurse-Led Continuity Of Care Program, Belinda Siri Mesape

Walden Dissertations and Doctoral Studies

At an outpatient primary care and behavioral health clinic, the practice problem is the high rate of patient no-shows and late appointment cancellations. Missed appointments are a problem, disrupting continuity of care and follow-up and potentially affecting patient outcomes. A comprehensive literature search was performed using PubMed/MEDLINE, CINAHL Complete, the Cochrane Library, PsycINFO, and Google Scholar. The search revealed 26 peer-reviewed studies. Literature consistently supports the use of multifaceted interventions to improve appointment adherence in outpatient settings. The project proposal consists of the development of an evidence-based practice (EBP) program proposal to address the gap in practice in improving appointment …

Alcohol Withdrawal Management Practices And Prevention Of Escalation Events In Hospitalized Adults, Danielle Logan

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice project was an organizational process evaluation examining alcohol withdrawal management among hospitalized adults. Alcohol withdrawal can cause severe agitation, seizures, delirium, behavioral emergencies, transfers, and prolonged hospitalization, making early recognition and evidence-based management essential to patient safety. The practice-focused question examined whether hospitalized adults experiencing alcohol withdrawal were assessed and treated proactively based on risk factors and clinical presentation or reactively after symptom escalation, and whether management practices contributed to Code Green activation and higher-level-of-care transfers. The purpose was to identify practice gaps and develop evidence-based recommendations to improve safety and consistency of care. A …

Increasing Postpartum Appointment Attendance Rates, Tanya Lister

Doctor of Nursing Practice Posters and Presentations

Background: Postpartum visits provide an opportunity to detect and address potential complications, monitor healing and recovery, and offer guidance and support during the transition into motherhood. Current research shows that appointment reminders increase healthcare appointment attendance rates, whether delivered via text messages or phone calls.

Purpose: The purpose of this academic project was to plan, implement, and evaluate a process change within a single health facility to increase postpartum visit attendance rates.

Methods: This evidence-based scholarly project used telephone calls to remind patients scheduled for postpartum visits of their appointment dates and times. Appointment reminder phone calls were completed the …

Increasing Postpartum Appointment Attendance Rates, Tanya Lister

Doctor of Nursing Practice Scholarly Projects

Background: Postpartum visits provide an opportunity to detect and address potential complications, monitor healing and recovery, and offer guidance and support during the transition into motherhood. Current research shows that appointment reminders increase healthcare appointment attendance rates, whether delivered via text messages or phone calls.

Purpose: The purpose of this academic project was to plan, implement, and evaluate a process change within a single health facility to increase postpartum visit attendance rates.

Methods: This evidence-based scholarly project used telephone calls to remind patients scheduled for postpartum visits of their appointment dates and times. Appointment reminder phone calls were completed the …

Early Post-Cesarean Anxiety, Nausea, Vomiting, And Pain Under Spinal Anesthesia: Trajectories And Modifiable Predictors, Indah Susanti, Eza Kemal Firdaus, Septian Mirova Sebayang, Amelia Andini, Alicia Dumes Berg, Margaret Atwood, Rantiningsih Sumarni, Mesya Mesya, Asmat Burhan

Jurnal Keperawatan Indonesia

Recovery after caesarean under spinal anesthesia remains a quality gap, with scarce evidence on modifiable anesthetic practices improving recovery. Data linking the neuraxial technique, nausea, anxiety, and pain remain limited. The objective of this study was to describe postoperative nausea and vomiting, anxiety, and pain at 6, 12, and 24 hours after caesarean section under spinal anesthesia and to examine whether intrathecal adjuvant use, sensory block level, fasting duration, and American Society of Anesthesiologists (ASA) physical status were associated with these outcomes. Cross-sectional study across five hospitals; 534 women undergoing caesarean under spinal anesthesia. Exposures: intrathecal adjuvant, sensory level (≤ …

Emotional Intelligence, Work Engagement, And Turnover Intention Among Hospital Nurses: A Hierarchical Component Analysis, Catrin Catrin, Christopher Wisnu, Pauline Henriette Pattyranie Tan

Jurnal Keperawatan Indonesia

High turnover intention among hospital nurses poses serious challenges to healthcare organizations, affecting service quality and workforce stability. Understanding the psychological and organizational factors associated with turnover intention is essential for developing effective retention strategies. This study aimed to examine the relationships among emotional intelligence, work engagement, and turnover intention among hospital nurses, including health-promoting leadership, workload, and burnout as contextual variables within the model. A cross-sectional study was conducted among 98 nurses working in inpatient units using validated questionnaires. The data were analyzed using partial least squares structural equation modeling (PLS-SEM) with hierarchical component analysis. Emotional intelligence significantly predicted …

Evaluating Mobile Palliative End-Of-Life Advanced Care Enhancement (Mpeace) Usability And Technology Acceptance: Mixed-Methods Design, Ni Luh Putu Inca Buntari Agustini, I Gede Putu Darma Suyasa, Israfil Israfil

Jurnal Keperawatan Indonesia

Palliative End-of-Life Care (PEoLC) is a process requiring timely assessment, effective communication, and personcentered decision-making to support patients and families. Although the process can be strengthened through digital health innovations such as Mobile Palliative End-of-Life Advanced Care Enhancement (M-PEACE), its use in PEoLC remains limited. Therefore, this study aimed to evaluate M-PEACE usability and technology acceptance through an explanatory sequential mixed-methods design and explore user experiences in describing quantitative results. The quantitative phase was conducted to assess usability through an adapted System Usability Scale (SUS), and technology acceptance was measured using a modified Technology Acceptance Model (TAM) questionnaire. A total …

Supportive And Palliative Care: Addressing The Unspoken Burden Of Cancer On Significant Others, Esmeraldo C. De Las Armas Iv

Jurnal Keperawatan Indonesia

A diagnosis such as cancer can cast a long-lasting gloom that affects not only the patient but also their loved ones. This concept analysis represents an effort to understand and explore the nuanced world of supportive and palliative care for significant others of cancer patients, a population that has often been overlooked. Rodgers’ evolutionary model of concept analysis was utilized to examine the concept of supportive and palliative care for significant others of cancer patients. Positive outcomes for both significant others and patients included improved coping mechanisms, reduced caregiver burden, enhanced communication, and better quality of life. However, several challenges …

Staff Education About Prescribing Glucagon-Like Peptide-1s (Glp1s), Deenis Garcia

Walden Dissertations and Doctoral Studies

Obesity is a growing health concern that affects many people. In recent years, the use of glucagon-like peptide-1 (GLP1s) has become increasingly popular to combat obesity. The use of GLP1s has shown successful outcomes, yet there are inconsistencies when prescribing the medication for weight loss. The practice problem identified at the organization was the lack of consistent and evidence-based guidance for providers to utilize when prescribing GLP1s for weight loss. The practice-focused question was to determine whether education on structured guidance tools for clinical staff who prescribe GLP1 medications improves their knowledge and intent to use these tools when prescribing …

Development Of A Proposal For An Occupational Safety And Wellness Program, Lodie Rogers

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) evidence-based practice project was a quality improvement initiative focused on developing and implementing an occupational safety and wellness program (OSWP) in an industrial organization. The practice problem was the absence of a formal, standardized program for injury prevention, near-miss reporting, hazard identification, employee wellness, safety education, and leadership accountability. Evidence from scholarly databases, Occupational Safety and Health Administration (OSHA) reports, organizational safety data, incident reports, near-miss documentation, and compliance measures supported the project. I examined how a 10-week OSWP can reduce employee incidents, improve safety culture, decrease injuries, increase engagement, and sustain wellness practices. …

Recognizing Appropriate General Inpatient Hospice Patients Time To Stop Normalizing Suffering, Oliver Charles Roth

Walden Dissertations and Doctoral Studies

Hospice patients experiencing uncontrolled pain, dyspnea, agitation, anxiety, delirium, or other severe symptoms may require General Inpatient (GIP) hospice care for intensive symptom management. However, inconsistent recognition of symptom crises can delay escalation to the appropriate level of care, contributing to unnecessary patient suffering, caregiver distress, and avoidable emergency department or hospital utilization. This Doctor of Nursing Practice executive leadership project evaluated the implementation of an educational framework designed to improve clinician recognition and timely escalation of patients who may be appropriate for GIP hospice care. Education emphasized early identification of uncontrolled symptoms, interdisciplinary communication, documentation, and escalation for clinical …

Development Of A Culturally Tailored Care Model For Chronic Disease Management In The Coastal Community: A Modified Delphi Study, Laode Saltar, Heltty Heltty, Sitti Mikarna Kaimuddin

Jurnal Keperawatan Indonesia

Chronic noncommunicable diseases (NCDs), particularly hypertension and type 2 diabetes mellitus, are increasing in Indonesia’s coastal communities including the Bajo population in Southeast Sulawesi. Limited healthcare access, cultural barriers, and low preventive health engagement exacerbate the disease burden in these communities. Culturally tailored interventions are needed to enhance self-awareness and improve chronic disease management. This study aimed to develop and validate a culturally sensitive care model for chronic disease management in the Bajo coastal community. A three-round modified Delphi method was used with 26 panelists representing health professionals, community leaders, policymakers, and family members recruited through community health centers and …

Environmental Exposure Risk Education To Enhance Chronic Kidney Disease Prevention And Screening For Nurse Practitioners, Kelsea J. Carrier

Doctor of Nursing Practice Scholarly Projects

Chronic kidney disease (CKD) affects approximately 36 million adults in the United States, with nearly 90% of individuals unaware of their diagnosis until advanced stages. While diabetes and hypertension remain the primary causes, increasing evidence highlights environmental exposures as significant and underrecognized contributors to CKD onset and progression. Exposures such as heavy metals, per- and polyfluoroalkyl substances (PFAS), air and water pollution, microplastics, and heat exposure have been linked to impaired renal function. Despite this growing body of evidence, environmental health content remains limited in nursing education, resulting in gaps in environmental health literacy (EHL) among nurse practitioners (NPs) and …

Bridging The Gap In Science Research: Preparing Students For College- Level Research In The Sciences, Victoria Helwig, Yaoguang Li

UConn Library Presentations

Many first-year students enter college unprepared to fully engage with scientific literature and academic library resources. Drawing on experiences from academic librarians working with STEM students, this session explores common gaps in science research skills, including navigating databases, identifying scholarly sources, and understanding the structure of scientific literature. Participants will be introduced to practical strategies and classroom-ready activities to better prepare students for college-level research. Discussion questions: What science research skills do students struggle with most when entering college? How can high school instruction better support these skills? Where can librarians and educators collaborate to support student success?

Limited Australian Clinical Guidelines For Pain Assessment In Hospitalized Older Adults With Cognitive Impairment: Implications For Safe And Quality Care, Rosemary Saunders, Kaoru Nosaka, Seng Giap Marcus Ang, Natasya Raja Azlan, Aaron Alejandro, Rohini Sharma Bhardwaj, Olivia Gallagher, Irene Ngune, Amineh Rashidi, Yan Hui Celestine Wee, Nilufeur Mckay

Research outputs 2022 to 2026

Introduction – Pain assessment remains challenging in healthcare settings in patients who are unable to self-report their pain. More than 50% of individuals with dementia and other forms of cognitive impairment (CI) experience pain daily. However, pain is frequently overlooked and inadequately assessed by healthcare professionals due to their lack of knowledge and guidelines to inform pain assessment. Pain is also a leading cause of hospital presentation and inappropriate pain assessment can impact on pain management and compromise safe and quality care. Evidence-based guidelines that inform appropriate pain assessment and management are therefore essential. This scoping review aimed to explore …

Enhancing Surgical Team Readiness: Simulation Training For Power Failure Response In Robotic Procedures, Heather Marie Sorton

Walden Dissertations and Doctoral Studies

In this Doctor of Nursing Practice (DNP) project, I used a quality improvement design to implement and evaluate a simulation-based education aimed at improving perioperative staff knowledge related to robotic power-loss events. A practice gap was identified in staff preparedness for robotic system failures due to limited education on emergency protocols, communication, team roles, and Association of PeriOperative Registered Nurses (AORN)-aligned response processes, impacting patient safety during robotic-assisted procedures. I examined whether implementation of a simulation-based educational intervention improved staff knowledge related to robotic power-loss management. The purpose of the project was to improve staff knowledge and standardize responses to …

The Fourth Trimester: Enhancing Postpartum Depression Detection In Primary Care Through Early Screening And Patient Education, Riley Goldschmidt

DNP Projects

Background:
Postpartum depression (PPD) is a common and often underrecognized complication, with many cases going undetected due to inconsistent screening practices in primary care. Delayed identification can negatively impact maternal well-being, infant bonding, and overall family health outcomes. This quality improvement project aimed to improve early detection of PPD by implementing routine screening and patient education during newborn visits in a primary care clinic.

Methods:
The intervention integrated the Edinburgh Postnatal Depression Scale (EPDS) into the existing newborn visit workflow and introduced an evidence-based educational toolkit containing information on PPD symptoms, guidance for seeking care, and a QR code for …

Improving Outpatient Provider Preparedness Through Simulation-Based Training: A Quality Improvement Project, Kristina Weyer

DNP Projects

Introduction:
Simulation-based training is an effective educational strategy, particularly for high-acuity, low-frequency events such as patient decompensation in outpatient settings. However, there is a gap in both literature and practice regarding provider participation in simulation, as competing clinical demands often limit engagement. Local organizational leaders identified limited opportunities for outpatient providers to practice management of acute decompensating patients. The purpose of this project was to evaluate provider competence and confidence in managing a decompensating patient in the outpatient setting and to assess perceptions of the value of time spent in simulation.

Methods:
This quality improvement project evaluated providers who participated …

Bridging The Gap: Development And Implementation Of A Caregiver Educational Guide For Post-Lung Transplant Caregivers, Megan Aller

DNP Projects

Background: Caregivers of post-lung transplant recipients play a critical role in postoperative recovery, as patients require continuous support during the first three months after transplant. Despite this responsibility, caregivers frequently experience burden, stress, and challenges adapting to the complex demands of the caregiving role.

Aim: To evaluate the feasibility and preliminary outcomes of a tailored caregiver education and support guide for caregivers of lung transplant recipients.

Local Problem: Within the local transplant program, caregiver education primarily relied on verbal instruction with limited caregiver-specific take-home resources.

Methods: This quality improvement project used a two-group pretest–posttest design to evaluate the …

Nurse-Led Quality Improvement Asthma Self-Management In Primary Care, Jolene Steinert-Abderhalden

DNP Projects

Background:
Poorly controlled asthma contributes to preventable morbidity, yet many adults lack consistent self-management support. Local Problem: Baseline assessment at a rural Midwestern clinic revealed limited asthma knowledge, inconsistent action-plan use, and low confidence among adults with Asthma Control Test (ACT) scores below 20.

Methods:
This quality improvement project used a pre- and post-intervention design guided by Lean methodology and the Plan-Do-Study-Act (PDSA) framework. Interventions: Registered nurses delivered standardized asthma education, inhaler-technique review, and action plan reinforcement with monthly structured follow-up for 16 weeks.

Results:
Among four enrolled participants, three completed follow-up. Mean ACT scores improved from 17.5 at baseline …

Evaluating Preoperative Education Modalities For Orthopedic Surgery Patients, Hannah Johnson

DNP Projects

Effective preoperative education is essential as total joint arthroplasty (TJA) procedures shift to outpatient care, yet traditional education methods may not be meeting patients’ diverse learning styles. This Doctor of Nursing Practice (DNP) project aimed to evaluate the impact of multimodal preoperative education (in-person, virtual, hybrid video modules, or a combination) on patient-reported anxiety and discharge readiness, as well as length of stay (LOS), surgical site infections (SSIs), and 30-day readmissions. The in-person portion could not be implemented due to staffing constraints. The pre-post evaluation was conducted with a sample of 273 patients undergoing elective hip and knee arthroplasty (pre …

Registered Nurse Procedural Sedation In Operating Room: An Analysis Of Patient Safety And Nurse Confidence Efficacy Of 2 Years Post Implementation, Cassandra Fredrickson

DNP Projects

Background
A Midwest hospital implemented a registered nurse (RN) procedural sedation program to provide safe, cost-effective sedation for selected operating room procedures under physician supervision, improving patient access while optimizing anesthesia resources.

Methods
A retrospective descriptive program evaluation examined 1,117 patients who received RN-administered procedural sedation for vascular and neurovascular procedures during 2022 and 2024. Outcomes included anesthesia consultation, anesthesia takeover, reversal agent use, and adverse events. Patient demographics and procedure duration were analyzed. Six procedural sedation nurses completed a self-efficacy survey assessing confidence in sedation-related competencies. Descriptive statistics and qualitative review of adverse event narratives were performed.

Results
Among …